Normative values for short-segment nerve conduction studies and ultrasonography of the ulnar nerve at the elbow

Background: Cubital tunnel syndrome is a common compressive neuropathy of the upper extremity. The anconeus epitrochlearis muscle is an unusual but occasional contributor. We review our experience with this anomalous muscle in elbows with cubital tunnel syndrome. Methods: We retrospectively reviewed charts of 13 patients noted to have an anconeus epitrochlearis muscle associated with cubital tunnel syndrome. Results: Ten patients had unilateral ulnar neuropathy supported by nerve conduction studies. Three had bilateral cubital tunnel syndrome symptoms with 1 of those having normal nerve conduction studies for both elbows. Eight elbows were treated with myotomy of the anconeus epitrochlearis muscle and submuscular transposition of the ulnar nerve. The other 8 elbows were treated with myotomy of the anconeus epitrochlearis muscle and in situ decompression of the ulnar nerve only. All but 1 patient had either clinical resolution or improvement of symptoms at follow-up ranging from 2 weeks to 1 year after surgery. The 1 patient who had persistent symptoms had received myotomy and in situ decompression of the ulnar nerve only. Conclusions: An anomalous anconeus epitrochlearis occasionally results in compression of the ulnar nerve but is usually an incidental finding. Its contribution to compression neuropathy can be tested intraoperatively by passively ranging the elbow while observing the change in vector and tension of its muscle fibers over the ulnar nerve. Regardless of findings, we recommend myotomy of the muscle and in situ decompression of the ulnar nerve. Submuscular transposition of the ulnar nerve may be necessary if there is subluxation.

Download Full-text

Ulnar Nerve Conduction Studies: Reference Standards with Extended Uncertainty in Healthy South Korean Adults

Journal of Electrodiagnosis and Neuromuscular Diseases ◽

10.18214/jend.2020.00157 ◽

2021 ◽

Vol 23 (1) ◽

pp. 1-10

Author(s):

Hyun Jun Chae ◽

Eunkyung Kim ◽

Jae Hyun Lee ◽

Goo Joo Lee ◽

Jihong Park ◽

...

Keyword(s):

Ulnar Nerve ◽

Nerve Conduction ◽

Reference Standards ◽

Nerve Conduction Studies ◽

South Korean ◽

Korean Adults ◽

Extended Uncertainty

Download Full-text

Median and Ulnar Nerve Conduction Studies in Young Adult Violinists

Medical Problems of Performing Artists ◽

10.21091/mppa.2000.3025 ◽

2000 ◽

Vol 15 (3) ◽

pp. 123-128

Author(s):

Elizabeth A Bowie ◽

Kristen M Brimer ◽

Melissa S Kidder ◽

Monica L Wallis ◽

Nancy S Darr ◽

...

Keyword(s):

Young Adult ◽

Upper Extremity ◽

Ulnar Nerve ◽

Nerve Conduction ◽

Normal Values ◽

Motor Nerve ◽

Nerve Conduction Studies ◽

Upper Extremities ◽

Physical Examinations ◽

Median Neuropathy

The incidence of musculoskeletal injuries among musicians is well documented. The purpose of this study was to describe the neural status of the median and ulnar nerves in young adult violinists. Twenty volunteer violinists were recruited from the Belmont University and the Vanderbilt University Blair School of Music Orchestras (age 18-30 years). The subjects completed a history form and underwent a physical examination. The electrophysiologic status of the median and ulnar nerves in both upper extremities was then evaluated using sensory and motor nerve conduction studies (NCSs). Upon completion of the NCSs, educational materials to prevent upper extremity cumulative trauma disorders were distributed to the subjects. In these subjects, the history and subjective examination were largely noncontributory of upper extremity neuropathies. Their physical examinations were also not diagnostic of upper extremity neuropathies. All subjects’ median and ulnar NCSs were normal when compared with a chart of normal values. However, when comparison studies between the median and ulnar NCSs in the same extremity were performed, seven subjects showed differences in their distal motor latencies (>1.0 msec) or distal sensory latencies (>0.5 msec) that could be suggestive of early median neuropathy at or distal to the wrist. In this descriptive study, 20 young adult violinists had no subjective findings of median or ulnar neuropathy, had normal physical examinations of the neck and both upper extremities, and had normal median and ulnar NCSs when compared with a chart of normal values. However, when comparison NCSs between the median and ulnar nerve in the same extremity were performed, seven violinists were found to have NCS values suggestive of early median neuropathy at or distal to the wrist. In this population of 20 young adult violinists, seven musicians were found to have electrophysiologic findings suggestive of early median neuropathy at or distal to the wrist.

Download Full-text

A Comparative Clinical and Electromyographic Study of Median and Ulnar Nerve Injuries at the Wrist in Children and Adults

Journal of Hand Surgery (European Volume) ◽

10.1054/jhsb.2000.0493 ◽

2001 ◽

Vol 26 (1) ◽

pp. 58-60 ◽

Cited By ~ 15

Author(s):

F. DUTEILLE ◽

D. PETRY ◽

L. POURE ◽

G. DAUTEL ◽

M. MERLE

Keyword(s):

Ulnar Nerve ◽

Nerve Conduction ◽

Clinical Results ◽

Nerve Conduction Studies ◽

Nerve Injuries ◽

Sensory Recovery ◽

Adults And Children

The outcome of 38 median and ulnar nerve injuries at the wrist in 15 adults and 15 children were studied with a follow-up of at least 1 year. Each patient was assessed clinically and with nerve conduction studies. The results confirm a markedly superior sensory recovery in children. However the children had persistent motor deficiencies. This difference in the clinical results of adults and children was not reflected in the nerve conduction results which were similar in both groups.

Download Full-text